Background:

Levosimendan (LEVO) is a positive inotropic drug which could increase myocardial contractility and reduce the mortality rate in cardiac surgical patients. However, Whether LEVO is associated with postoperative bleeding and blood transfusion in cardiac surgical patients is controversial. Therefore, the current study was designed to investigate the impact of LEVO administration on bleeding and blood transfusion requirement in off-pump coronary artery bypass grafting (OPCAB) patients.

Methods:

In a retrospective analysis, a total of 292 patients, aged 40–87 years, undergoing elective OPCAB between January 2019 and July 2019, were divided into LEVO group (n = 151) and Control group (n = 141). Patients in LEVO group continuously received LEVO at a rate of 0.1–0.2 μg kg⁻¹ min⁻¹ after anesthesia induction until 24 hours after OPCAB or patients in Control group received no LEVO. The primary outcome was postoperative chest drainage volume. The secondary outcomes were reoperation for postoperative bleeding, transfusion requirement of red blood cells (RBCs), fresh frozen plasma (FFP) and platelet concentrate (PC), etc. Comparisons of two groups were performed with the Student’s t-test or Wilcoxon-Mann-Whitney test.

Results:

There was no significant difference with respect to chest drainage volume ((956.29 ± 555.45) ml vs (1003.19 ± 572.25) ml, p = 0.478) and the incidence of reoperation for postoperative bleeding (1.32% vs 1.42%, p = 0.945) between LEVO group and Control group. The transfusion incidence and volume of allogeneic RBCs, FFP, and PC were comparable between two groups.

Conclusions:

LEVO administration was neither associated with more postoperative blood loss nor increased allogeneic blood transfusion requirement in OPCAB patients.

中文翻译：

---

左西孟旦给药与非体外循环冠状动脉旁路移植术患者出血风险和输血需求增加无关：一项单中心回顾性研究

背景：

左西孟旦（LEVO）是一种正性肌力药物，可以增加心肌收缩力，降低心脏手术患者的死亡率。然而，LEVO是否与心脏手术患者的术后出血和输血相关是有争议的。因此，本研究旨在调查 LEVO 给药对非体外循环冠状动脉旁路移植术 (OPCAB) 患者出血和输血需求的影响。

方法：

在一项回顾性分析中，2019 年 1 月至 2019 年 7 月期间接受择期 OPCAB 的 292 名年龄在 40-87 岁之间的患者被分为 LEVO 组（n = 151）和对照组（n =  141 ）  。LEVO组患者在麻醉诱导后持续接受0.1-0.2 μg kg ^-1  min ^{-1的LEVO直至OPCAB后24小时或对照组患者不接受LEVO。}主要结果是术后胸腔引流量。次要结局为术后出血再次手术、红细胞（RBCs）、新鲜冰冻血浆（FFP）和浓缩血小板（PC）的输血需求等。-测试或 Wilcoxon-Mann-Whitney 测试。

结果：

胸腔引流量（（956.29±555.45）ml vs（1003.19±572.25）ml，p = 0.478）和术后出血再次手术的发生率（1.32％vs 1.42％，p = 0.945）之间没有显着差异LEVO组和对照组。两组间异体红细胞、FFP 和 PC 的输血发生率和体积相当。

结论：

LEVO 给药与 OPCAB 患者术后失血量增加或同种异体输血需求增加无关。